腹腔镜联合胆道镜探查术治疗胆囊结石合并胆总管结石35例临床分析

目的对腹腔镜联合胆道镜(LCBDE)治疗胆囊结石合并胆总管结石的手术安全性及有效性进行临床分析。方法回顾性分析安徽医科大学第一附属医院急诊外科2014年8月-2017年6月35例胆囊结石合并胆总管结石行腹腔镜联合胆道镜手术的患者作为观察组,选择同时期35例采用传统开腹手术方法治疗的患者的临床资料作为对照组;比较两组患者手术治愈率,并发症发生率及结石残留率。结果观察组治愈32例,治愈率91.42%。对照组治愈29例,治愈率82.85%,观察组治愈率高于对照组,差异有统计学意义(P0.05)。观察组结石残留1例,发生胆漏经治疗后好转2例,中转开腹1例,并发症发生率5.71%,结石残留率2.85%,对照组结石残留3例,发生胆漏或胆道感染经治疗后好转6例,并发症发生率17.14%,结石残留率8.57%,观察组并发症发生率及结石残留率明显低于对照组,差异有统计学意义(P0.05)。结论LCBDE治疗胆囊结石合并胆总管结石手术安全性及临床有有效性明显优于传统开腹手术,手术治愈率高,并发症少,结石残留率低。

Clinical Analysis of Laparoscope Combined with Choledochoscope in the Treatment of Cholecystolithiasis with Choledocholithiasis

Objective To discuss the safety and effectiveness of laparoscope combined with choledochoscope in the treatment of cholecystolithiasis with choledocholithiasis.Methods From August 2014 to June 2017 in the first hospital of affiliated hospital,35 cases of cholecystolithiasis with choledocholithiasis treated with LCBDE were selected as the observation group;at the same time another 35 cases with the treatment of laparotomy were chosen as control group;and patients cured rate and complication rate of two groups were compared.Results In observation group,32 cases were cured and cure rate was 91.42％,while in control group,29 cases were cured and cure rate was 82.85％ . It was concluded that the cure rate in observation group was clearly higher than control group,the difference was statistically significant(P ＜ 0.05).In observation group,the calculi residual rate was 2.85％,and the complication rate was 5.71％;while in control group,the calculi residual rate was 8.57％,and the complication rate was 17.14％.The two groups were compared,the calculi residual rate and the complication rate in control group were obviously higher than observation group,the difference was statistically significant (P ＜ 0.05).Conclusion The safety and effectiveness of laparoscope combined with choledochoscope in the treatment of cholecystolithiasis with choledocholithiasis were superior to traditional laparotomy.